title: Evaluation of left ventricular systolic function with pulsed wave tissue Doppler in rheumatic mitral stenosis.
abstract: BACKGROUND
  Mitral stenosis (MS) is still the most common complication of acute rheumatic fever in Turkey. Rheumatic carditis affects not only cardiac valves but also myocardium. In this study, we aimed to evaluate the subclinical left ventricular (LV) systolic dysfunction and contraction of short and long axial circumferential and longitudinal fibers by pulsed wave tissue Doppler in rheumatic MS patients who have preserved LV systolic function in 2D echocardiography.
  
  
  METHODS
  Fifteen severe, 20 moderate rheumatic MS patients hospitalized for mitral balloon valvuloplasty, and 15 patients who had normal echocardiographic findings were included in the study. After routine conventional transthoracic echocardiographic examination, LV myocardial systolic velocities were evaluated with pulsed wave tissue Doppler in the short and long axis with simultaneous electrocardiographic monitoring.
  
  
  RESULTS
  Long axis first systolic velocity (SW1) of mild-moderate and severe MS was much lower than normal group (10.7 ± 2.3 in normal group vs. 7.9 ± 1.3 in mild-moderate MS group vs. 6.2 ± 1.4 in severe MS group, p < 0.001). Long axis Q-SW1 duration was longer in mild-moderate MS group (145 ± 32 in normal group vs. 199 ± 43 in mild-moderate MS group, p = 0.001). Short axis Q-SW2 duration was longer in normal group compared to mild-moderate and severe MS groups (298 ± 41 in normal group vs. 245 ± 37 in mild-moderate MS group vs. 234 ± 26 in severe MS group, p < 0.001). Significant correlation between mitral valve area and SW1, Q-SW1 was determined (p = 0.01).
  
  
  CONCLUSIONS
  Even if LV functions are normal with conventional 2D echocardiography, subclinical systolic dysfunction exists in MS. Also, there is a dyssynchrony between contraction of longitudinal and circumferential myofibrils.
authors.forename: Saadet
authors.initials: S
authors.lastname: Guven
authors.affiliation: Department of Cardiology, Dumlupinar University Kutahya Evliya Celebi Education and Research Hospital, Turkey. medicineman_tr@hotmail.com.
authors.forename: Taner
authors.initials: T
authors.lastname: Sen
authors.forename: Omac
authors.initials: O
authors.lastname: Tufekcioglu
authors.forename: Esra
authors.initials: E
authors.lastname: Gucuk
authors.forename: Belma
authors.initials: B
authors.lastname: Uygur
authors.forename: Erkan
authors.initials: E
authors.lastname: Kahraman
mesh_terms: D000328:Adult; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D015203:Reproducibility of Results; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*